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Biomedical subjects

G Holcberg

Publications and source records attributed to G Holcberg.

32 records · Page 2Linked to original sources
PubMed1995

Hypoglycemia: the price of intensive insulin therapy for pregnant women with insulin-dependent diabetes mellitus.

OBJECTIVE: To evaluate the risk of hypoglycemia associated with intensive insulin therapy of type I diabetes during pregnancy. METHODS: Eighty-four women with type I diabetes were recruited before 9 weeks' gestation and received intensive insulin therapy throughout pregnancy. Patients monitored glucose concentrations with memory glucometers, and insulin dosages were adjusted weekly accordingly. A detailed history of clinical hypoglycemic events was obtained at each weekly clinic visit. RESULTS: Clinically significant hypoglycemia requiring assistance from another person occurred in 71% of pregnant patients, with a peak incidence between 10-15 weeks. Severe hypoglycemia during the early weeks of embryogenesis was not associated with an increase in embryopathy. Glycemic control was similar in women with or without recurrent hypoglycemia, but glucose fluctuations were significantly greater in hypoglycemic women. CONCLUSION: Severe hypoglycemia is a significant maternal risk associated with intensive insulin therapy of pregnant women with type I diabetes. In women with recurrent episodes of hypoglycemia, the clear benefits of strict glycemic control must be weighed against the hazards of hypoglycemia.

Adult↗
PubMed1993

Pemphigus neonatorum.

The diagnosis of pemphigus neonatorum in an infant girl was based on clinical, histologic, and immunofluorescence evidence. The outcome was benign, and the skin lesions resolved within two weeks.

Female↗
PubMed1992

Copper metabolism--a factor in gestational diabetes?

The purpose of the present work was to investigate whether there is an involvement of copper metabolism in the mechanism of gestational diabetes mellitus. No statistically significant differences were found in serum copper and ceruloplasmin concentrations between healthy pregnant women and women with gestational diabetes mellitus. The activity of ceruloplasmin in women with gestational diabetes mellitus was slightly higher and its specific activity significantly raised. The CuZn superoxide dismutase activity was significantly increased (P < 0.05) in women with gestational diabetes mellitus, comparing the two groups by matched pairs according to age. The results indicate that oxidative stress may have a role in gestational diabetes mellitus and that reduced concentrations of copper are not the cause of this stress.

Adult↗
PubMed1992

[HIV infection in pregnancy].

The epidemic of human immunodeficiency virus (HIV) is now affecting populations that were less susceptible in the early 1980s. It is estimated that 8% of patients with AIDS in the US are women in the reproductive age, and 1% are children. In Israel up to 1992, 134 women and 14 children of infected parents were reported as carrying antibodies against the virus. A pregnant women who was a carrier prompted us to formulate various questions as to how the infection affects pregnancy and vice versa, proper management at delivery, rate and modes of perinatal transmission, risk to health care workers, and legal aspects of HIV infection in Israel.

Delivery, Obstetric↗
PubMed1992

Flow velocity analysis of umbilical and uterine artery flow in pre-eclampsia treated with propranolol or pindolol.

In a double blind study, 20 gravidas with pre-eclampsia were randomly allocated to treatment with either propranolol 120 mg/day or pindolol 15 mg/day for 7 days. Flow velocimetry was performed before and after treatment to assess the influence of these two regimens of beta blocker on the feto-placental circulation. A continuous wave Doppler unit was used to measure umbilical and uterine artery flow velocity waveforms. The systolic/diastolic (A/B) ratio and the systolic minus diastolic divided by systolic (A-B)/A ratio (resistance index) were used as indexes of blood flow resistance in the umbilical and uterine arteries, respectively. A resistance to flow in the uteroplacental circulation was significantly less in patients treated with pindolol compared to those treated with propranolol (P less than 0.01). The same pattern was also found in umbilical velocimetry, although the statistical significance was borderline (P = 0.06). Although both drugs were equally effective in reducing blood pressure at rest, their effect on the peripheral resistance was different. Pindolol appears to act in part through a peripheral vascular mechanism. Our data support this assumption because the flow in the uteroplacental bed, as reflected by a decrease in resistance index, improved when patients were treated with the drug pindolol.

Adult↗
PubMed1991

Improvement of psoriatic arthritis in a patient treated with bromocriptine for hyperprolactinemia.

We describe a woman with psoriatic arthritis who experienced a remarkable improvement of her skin and joint disease while only taking bromocriptine therapy. She was treated with bromocriptine for primary infertility due to hyperprolactinemia. The improvement in joint symptoms appeared to parallel that of the skin. More studies are required to determine the reproducibility of this observation.

Adult↗
PubMed1989

Reduction or cessation of fetal movements after steroid administration for enhancement of lung maturation. II: Analysis of blood flow velocimetry.

Reduction or cessation of fetal movements after intra-uterine exposure to pharmacological doses of steroids administered for enhancement of lung maturation has been previously reported. In the present study fetal activity and umbilical and uterine blood flow velocimetry in 18 pregnant patients receiving steroids were evaluated by ultrasonography. Measurements were done before, during and after steroid exposure in an attempt to clarify the possible pathophysiology of this peculiar change in intra-uterine fetal behavior. Even in cases in which mothers ceased to perceive fetal movements, on real-time sonography fetal activity was observed. The possible explanation for this phenomenon may be the influence of large doses of steroids that affected skeletal muscular activity. No changes in blood flow velocimetry in both uterine and umbilical arteries were observed throughout the study period, thereby indicating that the changes in fetal movements did not result from an altered blood supply.

Betamethasone↗
PubMed1988

Reduction or cessation of fetal movements after administration of steroids for enhancement of lung maturation. I. Clinical evaluation.

Changes in fetal activity ranging from reduction to cessation of fetal movements were observed in patients at the 25th to 34th week of gestation, who were receiving steroids for enhancement of fetal lung maturation. This was a transient phenomenon, and fetal movements returned to normal by 24 h after the last injection of steroids. Concomitantly, during the period of exposure to steroids, we found an increased incidence of nonreactive monitoring patterns on daily analysis of fetal heart monitoring tracing. Although the pathophysiology of these changes is still unclear, we believe that the practical value of this observation is of importance. Reduction or cessation of fetal movements and a nonreactive nonstress test are generally accepted signs of fetal compromise and considered as an indication for termination of pregnancy. In this selective group of patients this is a temporary phenomenon; therefore, conservative management would seem in order.

Betamethasone↗
PubMed1982

Outcome of pregnancy in 31 triplet gestations.

The course of gestation and labor and the outcome of 31 triplet pregnancies were analyzed. Early diagnosis is very important for improving the rate of fetal salvage in multiple pregnancy. The outcome of triplet pregnancies was better in the group of patients with induced ovulation than in the group with spontaneous ovulation. The most frequent antenatal complications were preterm labor (97%), pregnancy-induced hypertension (46%), and anemia (20%). In this series the favorable results were due to earlier diagnosis, prolonged hospitalization, and planned delivery, usually by cesarean section.

Adult↗
PubMedDate not supplied

Specific IgG and IgA antibodies to Chlamydia trachomatis in infertile women.

IgG, IgA, and IgM antibody titers to Chlamydia trachomatis were determined in sera of 80 infertile women and 100 controls by a single antigen (L-2) immunoperoxidase assay. The infertile women included 50 with unexplained infertility and normal hysterosalpingogram (HSG) and 30 with abnormal HSG. The control sera included 50 from primiparous and 50 from multiparous women. The prevalence of C. trachomatis IgG antibody was significantly higher in infertile women with abnormal HSG as compared with infertile patients with normal HSG and controls (87% v. 20% and 10%, respectively). The geometric mean titer (GMT) of C. trachomatis IgG antibodies of infertile women with abnormal HSG was significantly higher than those of controls (20.7 v. 5.6). A significantly higher prevalence of C. trachomatis IgA antibodies was found in infertile women with both abnormal and normal HSG than in controls (77% and 14% v. 3% respectively). No C. trachomatis IgM antibodies (less than 2) were found in any of the infertile or control groups. The possibility that serum C. trachomatis IgA antibodies may serve as a marker for early recognition of persistent C. trachomatis is discussed.

Adult↗
PubMedDate not supplied

Immunoperoxidase assay for detection of specific IgG and IgA antibodies to human spermatozoa in infertile women.

A new immunoperoxidase antibody-membrane antigen (IPAMA) technique for the detection of IgG and IgA antibodies specific for sperm antigens is described. The technique utilizes as antigen sperm cells dried on glass slides and stored at -70 degrees C. Sera of 82 infertile women, 50 primiparas, 50 multiparas and 25 children were tested by IPAMA. Results obtained with the IPAMA test for sperm-specific IgG are compared with the results obtained by the sperm immobilization test (SIT). By the IPAMA technique, 11 of 82 infertile women (13.4%) were positive for sperm-specific IgG antibodies, 12 (14.6%) for IgA antibodies and three (3.7%) for both. In the control groups only two of 125 subjects were positive for sperm-specific IgG and none for IgA antibodies. The difference in the prevalence of anti-sperm antibodies between the control groups and the infertility group was highly significant (P less than 0.001). There was agreement between the results of the IPAMA and SIT as to the presence or absence of antibodies in seven of the 11 IgG-positive sera in the infertility group. Four more sera were IgG positive by IPAMA only. The two positive sera in the control group were detected by both IPAMA and SIT. Since the IPAMA technique is simple, does not require special equipment and utilizes stored antigen, it seems that this method could be useful in mass screening of infertile couples.

Adult↗
PubMedDate not supplied

Selective vasodilator effects of atrial natriuretic peptide in the human placental vasculature.

OBJECTIVE: To determine whether atrial natriuretic peptide (ANP) attenuates the vasoconstrictor effects of angiotensin II (AII), a thromboxane mimetic (U46619), and endothelin-1 in the human fetal-placental vasculature and to determine whether nitric oxide (NO) has a role in the vasodilator activity of ANP. METHODS: Isolated placental cotyledons were dually perfused, with fetal perfusion pressure used as an index of vascular response. The effects of AII (10(-10)-10(-6) mol/L bolus injection), endothelin-1 (10(-7) mol/L bolus), and U46619 (10(-9)-10(-6) mol/L bolus or 10(-8) mol/L infusion) were established in the absence or presence of ANP (10(-8) mol/L). The role of NO as a mediator of ANP action was investigated by perfusion with n-nitro-L-arginine (NNLA, 10(-3) mol/L), an inhibitor of NO synthase. Statistical significance was determined by analysis of variance. RESULTS: Atrial natriuretic peptide caused significant attenuation of vasoconstrictor responses to AII, but weak attenuation of endothelin-1 and no attenuation of U46619. Use of NNLA did not affect the attenuation of AII-induced vasoconstriction by ANP. CONCLUSIONS: Atrial natriuretic peptide is a vasodilator of the fetal-placental vasculature constricted with AII and endothelin-1, but not with U46619. Nitric oxide does not mediate the action of ANP.

15-Hydroxy-11 alpha,9 alpha-(epoxymethano)prosta-5↗